Bipolar I vs Bipolar II Disorders Bipolar I alternation between major

Bipolar i vs bipolar ii disorders bipolar i

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Core clinical features of Major Depressive Disorder vs. Bipolar I vs. Bipolar II Disorders Bipolar I - alternation between major depressive episodes and manic episodes
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Bipolar II - alternation between major depressive episodes and hypomanic episodes Major Depressive Disorder Clinical features One or more major depressive episodes separated by periods of remission Single episode- highly unusual Recurrent episodes- more common New DSM-5 Diagnoses and controversy Premenstrual dysphoric disorder Significant depressive symptoms occurring prior to menses during the majority of cycles, leading to distress or impairment Controversial diagnosis Advantage: Legitimizes the difficulties some women face when symptoms are very severe Disadvantage: Pathologized an experience many consider to be normal Persistent Depressive Disorder (different types) vs. Major Depressive Disorder Persistent depressive disorder (dysthymia) is defined as depressed mood that continues at least 2 years, during which the patient cannot be symptom free for more than 2 months at a time even though they may not experience all of the symptoms of a major depressive episode. Different types of PDD Mild depressive symptoms without any major depressive episodes (“with pure dysthymic syndrome”) Mild depressive symptoms with additional major depressive episodes occurring intermittently (previously called “double depression”) Major depressive episode lasting 2+ years (“with persistent major depressive episode” Diagnostic Specifiers (only the ones covered in slide) PDD At least two years of depressive symptoms Depressed mood most of the day on more than 50% of days No more than two months symptom free Symptoms can persist unchanged over long periods (≥ 20 years) May include periods of more severe major depressive symptoms Major depressive symptoms may be intermittent or last for the majority or entirety of the time period Refer to lecture on mood disorder and suicide slides 16-17 Diagnostic Specifiers for depressive disorders Specifier: Additional diagnostic label used to convey extra information about symptoms Psychotic features specifier Major depressive episodes which also include some psychotic features Hallucinations: Sensory experience in the absence of sensory input Delusions: Strongly held inaccurate beliefs Anxious distress specifier
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Depression is accompanied by several significant symptoms of anxiety Predicts poorer outcome Mixed features specifier Depressive episodes which also include several manic symptoms Onset and Duration of Depressive Disorders Rare in childhood Risk increases in adolescence and young adulthood Mean age of onset = 30 Earlier onset of persistent depression associated with worse outcome Depressive episodes are variable in length Usually last several months untreated, but may last several years Disruptive Mood Dysregulation Disorder and purpose for addition to DSM-5
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  • Fall '09
  • zalava
  • Professor Navarro

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